Responding to Critical Incidents. Resource materials for Youthreach & Community Training Centres

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1 Responding to Critical Incidents Resource materials for Youthreach & Community Training Centres July 2014

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3 These materials may be used with centre staff, young people, and parents as appropriate. They are referenced in the text of the Guidelines for Youthreach and Community Training centre staff. The codes R1, R2 etc are used in the text for brevity. Table of Contents R1: Learner contact record... 7 Resource for centres... 7 R2: Sample consent letter Individual or group support session... 8 Resource for centres... 8 R3: Sample letter: Seeking advance parental agreement to their child being seen... 9 Resource for centres... 9 R4: Sample letter to parents sudden death/accident Resource for centres R5: Sample letter to parents violent death Resource for centres R6: Sample announcement to the media Resource for centres R7: A centre session following news of a critical incident Handout for staff members Step 1: Giving the facts and dispelling rumours Step 2: Sharing stories Step 3: Normalising the reactions Step 4: Worries (young people with learning difficulties) Step 5: Empowerment Step 6: Closure Step 7: Free time Step 8: Recovery R8: Children s understanding and reaction to death according to age Handout Ages 0 2 years Ages 2 5 years Ages 5 9 years Ages 9 12 Years Adolescents

4 R9: Stages of Grief Handout Denial, numbness, shock Acute grief/searching and longing for deceased Adaptation to life without the deceased Normalisation of life R10: How to cope when something terrible happens Handout for learners R11: Reactions to a critical incident Handout for learners R12: Grief after suicide or suspected suicide Handout for learners R13: Reintegration of the bereaved young person/young people in a centre Handout for centres R14: Ways to help your son/daughter through this difficult time Handout for parents R15: A general interview guide for mentors and other designated staff Handout for staff members R16: Checklist Young people at risk Handout for centres R17: Exploring suicide risk Guideline for centres R18: Frequently Asked Questions Guideline for coordinators/managers Q. What do I do first on hearing news of the incident/death? Q. Whom do I contact for help? Q. What should I do first thing on the first morning back at the centre? Q. What should be on the agenda for this meeting? Q. How do I handle all the phone calls? Q. How do I keep staff up to date? Q. How do I dovetail the centre s part in the funeral with the wishes of the parents...27 Q. How do I handle staff members who want to opt out? Q. How do I handle the media? (See Section 8 Dealing with the media) Q. What/when should I tell staff/the centre learners about the incident? Q. What if I feel upset myself and find it difficult to talk? Q. What if some young people do not appear to grieve? Q. How long does it take to come to terms with bereavement?

5 Q. How soon should brothers and sisters or friends be encouraged to return to the centre? Q. Where a lot of well-intentioned friends are calling to the house and perhaps staying out late at night, what should I advise a grieving family to do? Q. What can I do about phone texting or internet chatting, especially if unreliable (or inappropriate) messages are being passed about? R19: Frequently Asked Questions Guideline for staff members Q. I would like to opt out of support type work for personal reasons. Is this OK? Q. I have no qualifications to help out in this area. Shouldn t the job be left to the experts? Q. What should I do in the centre to be helpful? Q. What are the signs of grief that I may notice in learners? Q. What if I think that some young people are not grieving normally? Q. What skills do I have that are important? Q. Is there any one important thing I should say? Q. Is it a good idea to organise a centre session following a critical incident? Q. What should I do if I feel that a learner needs more professional support? Q. What is the overall message in helping bereaved young people? Q. When should I get back to a normal routine with a group of learners? Q. What do I do about the dead learner s belongings etc? Q. Is there a danger that by talking about suicide you make it appear to be an option for others? R20: Frequently Asked Questions Guideline for parents Q. This traumatic incident has upset my daughter/son. As there are many rumours circulating, I would like to know what really happened. How can I find that information? Q. Will help be available to my son/daughter in the centre? Q. How can I help my young person? Q. How long will the symptoms of grief last? Q. Since the incident occurred my son/daughter has difficulty in sleeping, complains of headaches etc 32 Q. If my son/daughter remains very upset what should I do? Q. In what ways are adolescents different from other young people? R21: Critical Incident Policy & Plan Framework Resource for centres Critical Incident Policy Critical Incident Team (CIT) Confidentiality and good name considerations Critical incident rooms Consultation and communication regarding the plan

6 R22: Critical Incident Template for centre plan Resource for centres Critical Incident Team Short term actions Medium term actions Follow-up R23: Emergency Contact List Resource for centres R24: SUGGESTED READINGS AND RESOURCES Resources for centres, staff and parents Texts useful for consultations or for working with teenagers Resources on Suicide Useful websites Helplines

7 R1: Learner contact record Resource for centres This form can be used by centre staff to record the details of learners seen following a critical incident. This information should be collated centrally. Name of centre staff member: Date Learner s name Outcome (include need for follow-up) 7

8 R2: Sample consent letter Individual or group support session Resource for centres This letter can be used as a template for centres when they are seeking parental consent for a young person to be seen in a group, or individually by a psychologist/counsellor outside the centre. Dear Parents You may already know that the centre staff have been providing support to our young people following (specific reference to the incident). Additional support is also being provided to our young people by (e.g. HSE etc.) personnel and others. These professionals will be available, where necessary, to meet individuals or groups of learners to help them during this difficult time. The aim of such sessions will be to: a) Provide information about dealing with grief and loss in a healthy way b) Allow learners the opportunity to express their thoughts and feelings in a safe and confidential environment c) Allow young people time to comfort and support each other d) Help young people resume their normal routines as soon as possible. If you would like your son/daughter to participate in a group or follow up session please give your consent by signing the form below. You should return it to the centre immediately. If you have any questions, please contact (Name and phone number of contact person). I give my consent for to participate in a group/individual Session young person s name Parent or Legal Guardian Date Yours sincerely Centre Coordinator/Manager 8

9 R3: Sample letter: Seeking advance parental agreement to their child being seen Resource for centres This letter can be used as a template for centres that decide to seek advance parental consent so that a young person may be seen by a guidance, counselling or psychological service practitioner (in a group or individually) in the aftermath of a critical incident. It is to cater for the situation where parents cannot be contacted. Dear Parent (Name of centre) has developed a plan for responding when a tragedy occurs. When such an event happens, we may be able to access support from outside agencies. If we feel it is necessary we would like to be in a position to have your son/daughter seen by a counsellor or psychologist who can offer them advice and support. Before any young person is seen by a psychologist/counsellor, we will make every effort to obtain parental consent. However, in the event of being unable to contact you, we are writing to seek your consent for your son/daughter to be seen by a support practitioner as part of our centre s immediate response. This allows us to support your son/daughter in the best way possible. Your son/daughter may be seen individually, in a small group or as part of a larger group. Please contact me should you wish to discuss this. Yours sincerely, Coordinator/Manager s name Centres should choose whether to use Option A or B below. Option A If you do not wish to have your son/daughter seen by a psychologist/counsellor, please fill in the form below and return to (name of staff member) I have read this letter and I do not wish to have.. seen by a psychologist/counsellor. Parents/carers: Date: Option B. Please fill in the form below confirming that you have read this letter and stating whether you wish or do not wish to have your young people seen by a psychologist/counsellor and return to. I have read this letter and I wish to have.. seen by a psychologist/counsellor in the event of a critical incident. I do not wish to have.. seen by a psychologist/counsellor in the event of a critical incident. Parents/carers: Date: 9

10 R4: Sample letter to parents sudden death/accident Resource for centres This letter can be used as a template for centres when informing parents of a tragedy. It offers some advice and outlines what is involved in the centre s response. Dear Parents The centre has experienced (the sudden death, accidental injury) of one of our young people. We are deeply saddened by the deaths/events. (Brief details of the incident) Our thoughts are with (family name). We have support structures in place to help your son/daughter cope with this tragedy. (Elaborate) It is possible that your son/daughter may have some feelings and questions that he/she may like to discuss with you. It is important to give truthful information. You can help your son/daughter by taking time to listen and by encouraging them to express their feelings. All young people are different and will express their feelings in different ways. It is not uncommon for some to have difficulty concentrating or to be fearful, anxious, or irritable. They may become withdrawn, cry, complain of physical aches and pains, have difficulty sleeping or have nightmares. Some may not want to eat. These are generally short term reactions. Over the course of the days to come, please keep an eye on your young person and allow him/her to express their feelings without criticism. Although the centre will continue as usual, I anticipate that the next few days may be difficult for everyone. (Optional) An information night for parents is planned for (date, time and place). At that time, further information about helping young people to grieve will be given. We have enclosed some information which you may find useful in helping your child through this difficult time. If you would like advice you may contact the following people at the centre. (Details) Coordinator/Manager signature 10

11 R5: Sample letter to parents violent death Resource for centres This letter can be used as a template for centres when they are informing parents of a violent death, offering some advice and outlining what the centre s response involves. Dear Parents I am informing you about a very sad event that has happened. (Give accurate information about the incident, but avoid using words such as murder or suicide as the facts will not be established until a court case or inquest has been held) A young person from the neighbourhood, who is the (brother, sister, cousin, friend) of, a learner here at the centre, died as a result of (a violent attack, violent incident in the street etc.) earlier this week. We are all saddened greatly by his/her death. We have shared this information and discussed it with all of our learners. Staff members have been available for all our young people today. Other support personnel (including psychologists etc., according to actual arrangements) are available to advise staff and, where necessary to talk to the young people. This support will continue to be available for (specify time). The death of any young person is tragic, but a violent death is even more difficult. Death may cause a variety of reactions in your son/daughter. Some young people are afraid for their own life and for the lives of those they love. Take time to listen to their fears and reassure them that sudden deaths are rare. We have enclosed some additional information that may be useful during this time. The media are around the centre and may approach you or your son or daughter. You need not respond to their questions if you are approached. We will not allow the media to interview your son/daughter at the centre and our general advice is that you should not let your child be interviewed as they may say something they will regret later. (If planned) A support meeting for parents is planned for (date, time and place). Our thoughts are with (family name) and with each of you. Yours sincerely 11

12 R6: Sample announcement to the media Resource for centres An announcement from the centre can be ed, faxed or given to the media. It may decrease the number of calls and callers to the centre from the media. In some instances, it is not appropriate to provide names or information that might identify individuals in the media statement. This announcement needs to take account of confidentiality issues, the wishes of the victim s family and the nature of the incident. My name is (Name) and I am the Coordinator/Manager of (Name) Centre. We learned this morning of the death of (one of our young people or the name of the person). This is a terrible tragedy for family(ies), our centre and our community. We are deeply saddened by these events. Our sympathy and thoughts are with (name) family and friends Name of young person was a learner/trainee at the centre and will be missed greatly by all who knew him/her. We have contacted his/her parents. They have indicated their need for privacy at this difficult time. Our centre has implemented our critical incident plan. We appreciate all the offers of help and support made. Psychologists and counsellors from and (insert other information if relevant) have been with us all day supporting and advising staff to assist our learners at this time The staff have been helping and supporting our young people to deal with the tragic event. The centre has been open to parents, to support them and to offer them advice and guidance. We would ask you to respect our privacy at this time. Thank you. 12

13 R7: A centre session following news of a critical incident Handout for staff members Normally, the Coordinator/Manager, or staff member who knows the learners/trainees best, should be the person to inform them of the events and lead the centre session. Young people generally feel safe and secure with someone they know. If the staff member feels uncomfortable with this role, another member of staff, or the guidance, counselling or psychological practitioner may share this task. Staff members should be able to opt out of this work if they feel personally vulnerable. Other arrangements can be put in place for that group of learners. The purpose of this session is to break the news, allow the young people to discuss the event and to express their thoughts and feelings in a secure environment. The staff member needs to listen and be empathic. Ideally, the session will be tailored to meet the young people s needs. The session outline may include: Step 1: Giving the facts and dispelling rumours Step 2: Sharing stories and allowing and encouraging the sharing of thoughts and the expression of feelings Step 3: Normalising the reactions Step 4: Dealing with young people s worries Step 5: How to share the news with others through face to face or internet communication Step 5: Empowerment Step 6: Closure Step 7: Free time Step 8: Recovery Step 1: Giving the facts and dispelling rumours. Tell the young people in a calm, low key and factual voice - What has happened - Who was involved? - When it happened - The plan for the day Sample script I have something very sad I want to share with you. (The factual information agreed on by the staff, for example) Joe Smith, who attends our centre and was missing, has been found. He is dead. Yesterday the Gardaí found his body. They are investigating what happened and will let us know when they find out more information. I am feeling very sad about what s happened. Let s spend some time together now helping each other to talk about how we feel about (name of the one who died). Step 2: Sharing stories Take some time for discussion. Young people may wish to tell their story of the event. As a result they will feel less alone because of their common shared experiences. Assisting them to verbalise or otherwise express their feelings helps recovery. Give the learners a choice of how they might like to represent their experiences. It is useful to have boxes of tissues around the centre. 13

14 Sample script To help us today, we are going to make a memory box for (name of deceased). You can draw a picture of a time you remember with (name of the deceased) or write a poem or a letter to him. If you like we can make a (box, memory book, etc.) and give it to (name of deceased) family sometime soon. This may help them to understand how important (name of deceased) was to us. Step 3: Normalising the reactions Tell the young people that they may all react differently to what has happened. There is no right or wrong way. List some possible feelings (See R11). Explain that their reactions are normal responses to abnormal circumstances. Let the learners know that the reactions or symptoms will go away in time. Tell them that if the symptoms do not diminish after a few weeks, they should let you or their parents know. They may need to talk to someone about how they are feeling. Distribute handouts R9, R10, R11, R12 as appropriate. Step 4: Worries (young people with learning difficulties) Sample script You may be worried about (name of the deceased) that they might be sad or lonely or hungry or cold. When someone dies they don t feel cold, hungry or sad any more. You may be worried that the same thing could happen to you or someone in your family. What happened to (name of deceased) doesn t happen very often. If the classmate has been ill, you could say He was very sick and the chances of this happening to someone else you know are low. Step 5: Empowerment Help the learners to identify strategies that they might use to help manage symptoms. For example, talking to family and friends, getting enough sleep, or taking exercise may help. If appropriate, the learners can share strategies that worked for them in other stressful situations or brainstorm ideas as to what else might be useful. Overall, it is important to help the young people regain a sense of control. Step 6: Closure End the session by focussing on the future. Depending on the nature of the incident, help the class/group decide what they would like to do about various issues, e.g., what to do about the person s belongings or about writing cards or letters. Reiterate the message that their reactions are normal responses to abnormal circumstances. Step 7: Free time After the discussion, the staff member may want to allow the learners some sports activity or some free time in the centre, depending on circumstances. Step 8: Recovery It may be useful to continue these activities at intervals during the day and to intersperse them throughout the centre s timetable for the following week/s. Normal routines should generally be resumed as soon as possible. Young people should be encouraged to resume sports and other extra-curricular activities. Help learners to identify or establish some supports; help them to identify relevant people for different kinds of help. It is appropriate that the centre s activities are adjusted or adapted. For example, presenting complex new 14

15 learning material following an incident may not be useful as concentration may be impaired. Use opportunities in ordinary class work, where coping and support can be reinforced. Discussions on what has been learnt from the critical incident and how to avoid future crises may be helpful. The centre s social, personal, and health education programme may also offer opportunities for structured discussions. 15

16 R8: Children s understanding and reaction to death according to age Handout May be of use to learners children or younger family members affected by the tragedy Young people s understanding and reaction to death will depend on their age and their developmental stage. The following are guides only as young people will differ in their reactions and grasp of events for a range of reasons other than age alone. Ages 0 2 years Infants do not understand the meaning of death They may display anxiety when separated from a loved one They may appear upset, subdued and uninterested in their surroundings. Ages 2 5 years No understanding of the permanency of death May search for the missing person May feel responsible for the death in some way May become apathetic and depressed May regress to an earlier stage of development e.g. thumb sucking, bedwetting, tantrums or may become clingy etc. May develop fears of going to sleep May worry that other loved ones may die. How you can help Continuity of normal routine e.g. mealtimes and bedtime Offer physical comfort Explain the death in clear simple language, using words like dead and died. Do not use terms like gone to sleep or passed away You may need to repeat the same information again and again Permit them to ask questions and be consistent in your answers Reassure them that they had nothing to do with the death and of the well-being of other family members. Ages 5 9 years Beginning to realise the permanency of death, but their idea of life after death is still vague May have concerns about how the deceased is feeling or thinking in the grave May have a lot of questions about aspects of the death e.g. how the person died, what they looked like, the funeral, heaven, coffins etc The reaction of their peers is important, may feel different to them Their peers may be awkward about the death and avoid contact They may become the target of bullying. How you can help Encourage the young people to talk and cry about the deceased if they wish to, otherwise respect their silence Answer questions and provide as much factual information about the death as possible 16

17 Reassure them that thinking and feeling ceases after death Be vigilant in relation to bullying. Ages 9 12 Years Understand the finality and universality of death Awareness of their own mortality and may worry about their own death May display psychosomatic symptoms May wish to stay at home close to parents May display anger. How you can help Dispel fears about their own health or the health of other loved ones by offering reassurance Encourage them to go to about their normal activities Allow them to express their anger, offering appropriate ways to do so. Adolescents Fully understand the finality, universality and inevitability of death. Their experience of death is similar to adults May feel a range of feelings: guilt, regret, anger, loneliness etc. Death adds to the already confused array of emotions May appear to not care about the death May seek support outside of the family. How you can help Offer them time to listen Allow them to express their grief in their own way Be prepared for mood swings. If parents are grieving themselves, they may be emotionally unable to support their son/daughter. In this instance, another supportive adult in the young people s life, e.g. other family members, friends, neighbours may need to offer emotional support. It should be remembered that for young people with special educational needs, their understanding of what has happened will be in line with their developmental age. 17

18 R9: Stages of Grief Handout May be used with various groups and individuals Grief is a normal, healthy and predictable response to loss. Although there are distinct phases in the grieving process, people go through these stages in different sequences and at different paces. Generally, the grieving process in adults is thought to take about two years. With children and adolescents, the process may take a more extended time-frame. Different issues may arise as the young people pass through their developmental milestones. Denial, numbness, shock (up to 6 weeks) Death of the person may be denied Emerging feelings may be suppressed Refusal to talk about the death Bereaved keeps very busy to avoid thinking about the death Bereaved may show signs of confusion and forget everyday routines Young people in shock may display either silent withdrawal or outbursts of crying/screaming. Acute grief/searching and longing for deceased (6 weeks to 4 months) Acute sadness crying Physical pangs of pain including loss of appetite and disturbed sleep Emotional pain accompanied by dejection, hopelessness, lack of concentration Fears of life after death, nightmares, ghosts Disorganisation Strong guilt feelings and questioning of self and others, particularly in the case of a sudden death Feelings of anger at the departed for leaving them Bereaved may reject offers to comfort them. Adaptation to life without the deceased (6 months to 18 months) People begin to adjust to their lives without the person who is gone Sense of isolation Fearful of forgetting the deceased Less crying and irritability Exacerbation of existing personality problems. Young people with low self-esteem may be at a greater risk of emotional behavioural difficulties. Normalisation of life Getting on with life Returned sense of humour and play Able to participate emotionally in new relationships Changed relationship with the deceased able to think of the deceased without pain Reduction in physical/emotional symptoms Less guilt. 18

19 R10: How to cope when something terrible happens Handout for learners Reach out people do care. Talk to your friends, family and the centre s staff members. Talking can be healing medicine. Remember you are normal and having normal reactions don t label yourself as crazy or mad. It is ok to cry. It is ok to smile and laugh. If your feelings and reactions seem different from those of your friends, remember everyone reacts differently. When the stress level is high there is a temptation to try to numb the feelings with alcohol and drugs. This complicates the problems, rather than relieving them. Some people find that writing or drawing is helpful. What about writing a note or letter to the family of the person who died or the person themselves? Spend time with people who have a positive influence on you. Make as many daily decisions as possible. This will give you a feeling of control over your life, e.g. if someone asks you what you want to eat answer them, even if you re not sure. Recurring thoughts, dreams or flashbacks are normal don t try to fight them they ll decrease over time and become less painful. Make a special effort to look after yourself during this time. Try to get some extra sleep, eat nutritious foods and get some exercise, even if it is just a walk. Sticking to your normal routine helps. Structure your time and keep busy. Take time out go for a walk or kick a football. Provide some balance to the negative things that have gone on by doing something fun or special. Think about something that makes you feel good. Then make it happen like going to the cinema, listening to music, calling a friend, etc. Laughter is good medicine. Watch a funny movie or play a silly game with younger people to lighten your spirits. Visit useful websites such as Be conscious of what you post on Facebook or anywhere else on the internet (photos or comments) or send on your phone. Above all, realise that what you are experiencing is normal following a traumatic event. Be understanding and kind towards yourself and others. 19

20 R11: Reactions to a critical incident Handout for learners As a result of this traumatic event, you may experience some strong emotional or physical reactions. There is no right or wrong way to feel but here is a list of difficulties you might experience. EMOTIONAL Fear Guilt Shame Anger Regret Loneliness Anxiety Mood swings Shock Yearning Numbness Confusion Isolation Insecure feelings THOUGHTS Disbelief Denial Sense of unreality Preoccupation with images of the event/person BEHAVIOURAL Nightmares Social withdrawal Irritability Tearfulness Loss of concentration Forgetfulness Physical/verbal aggression Misuse of drugs, including alcohol Excessive internet use PHYSICAL Tiredness Sleeplessness Headaches Gastrointestinal Problems Bowel/Bladder problems Loss or increase in appetite 20

21 R12: Grief after suicide or suspected suicide Handout for learners Remember there is no right or wrong way to react when someone you know dies. People will have many different reactions to what has happened. Know that you can survive, even if you feel you can't. You may feel overwhelmed and frightened by your feelings. This is normal. You're not going crazy; you are grieving. You may not feel a strong reaction to what has happened. This is okay. You may experiences feelings of guilt, confusion, forgetfulness and anger. Again these feelings are all normal. You may feel angry at the person who has died, at yourself, at God, at everyone and everything. It is ok to express it. You may feel guilty about what you did or did not do. Suicide is the act of an individual, for which we cannot take responsibility. You may never have an answer as to why but it is ok to keep asking why until you no longer need to ask or you are satisfied with partial answers. Sometimes people make decisions over which we have no control. It was not your choice. Feeling low is temporary, suicide is permanent. Suicide is a permanent solution to a temporary problem. If you are feeling low or having a difficult time, ask for help. Allow yourself to cry, this will help heal. Healing takes time. Allow yourself the time you need to grieve. Every person grieves differently and at a different pace. Delay making any big decisions if possible. This is the hardest thing you will ever do. Be patient with yourself. Spend time with people who are willing to listen when you need to talk and who understand your need to be silent. Seek professional help if you feel overwhelmed. If you are thinking of trying to kill yourself, you must talk to a trusted adult. Avoid people who try to tell you what to feel and how to feel it and, in particular, those who think you should be over it by now. Ask in the centre about a support group that provides a safe place to express your feelings, or somewhere to be with other survivors who are experiencing some of the same things you are feeling. Allow yourself to laugh with others and at yourself. This is healing. Useful websites:

22 R13: Reintegration of the bereaved young person/young people in a centre Handout for centres Here are some suggestions that may help the centre s response and facilitate the bereaved young person s return. They assist the individual, other students/learners and the staff to feel more comfortable. Visit the bereaved learner at home. Ask them what would they like to happen on their return to the centre? Talk to the centre s learners about how people are affected by grief and encourage them to share their own feelings. Ask about how they have coped with bereavements in their own lives and what has helped. Discuss how difficult it may be for a bereaved learner to come back to the centre. Ask other learners how they would like to be treated if they were returning to the centre after a death. This might be done in pairs or small groups, thus encouraging all to be involved. It will also ensure that a range of preferences are expressed, reinforcing the fact that different people have different preferences as to how they are treated. Some people may want to discuss what has happened, while others may want to be left alone. In general, bereaved young people say that they would like others to treat them normally rather than being over-nice to them. However it is a delicate balance as they don t want people to behave as if nothing has happened at all. It may help if, in advance of the bereaved learner s return to the centre, their peers have sent them cards or notes. This will let them know that they are in their thoughts. When they return, acknowledge their loss, I m sorry that (name of deceased) died. I know this is a very difficult time for you. (Check that this is done at the start of the day and not in every session. Staff members can express their own sympathies separately once the general re-entry to the centre has been managed.) When the young person returns, they may have difficulty concentrating or joining in session activities. Be understanding. Allow them access to a quiet room where he/she can go to be alone. You might suggest: We can set up a signal for you to use if you need to leave the session at any time. (Ensure supervision.) Link the bereaved young person in with supportive agencies or professionals if needed. Listen when they want to talk: If you need to talk at any time, I am here to listen Carry on normal routines and normal approaches to discipline. They may have difficulty completing assignments: If you are having difficulty doing your work, it is ok to just do what you can. Allow them as much time as they need to grieve. 22

23 R14: Ways to help your son/daughter through this difficult time Handout for parents Young people do not need to be taught how to grieve. They will do it naturally and in healthy ways if we allow them and if we provide the safety, atmosphere, permission and example to do so. Listen carefully. Let them tell their story. Tell them that the reactions they are having are normal. Pay extra attention, spend extra time with them, be more nurturing and comforting. Reassure them that they are safe. Don t tell them that they are lucky it wasn t worse. Traumatised people are not consoled by such statements. Instead, tell them that you are sorry such an event has occurred and you want to understand and help them. Do not be surprised by changes in behaviour or personality. They will return to their usual selves in time. Don t take their anger or other feelings personally. Help them to understand the relationship between anger and trauma. Help them find safe ways to express their feelings e.g. drawing, exercise, or talking. Help them to understand that defiance, aggression and risk behaviour is a way to avoid feeling the pain, hurt and or fear they are feeling. When going out, let them know where you are going and when you will be back. Telephone if you are out for a long time and reassure them. Tolerate regressive behaviour such as nail biting. Share your own experience of being frightened of something and getting through it. If they are feeling guilt or shame, emphasise that they did not choose for this to happen and that they are not to blame. Even if they were angry with the person who died, or had been mean to them, this did not make it happen. Work with the centre s support services and other available support agencies. 23

24 R15: A general interview guide for mentors and other designated staff Handout for staff members This can be used to help explore a learner s reaction to a critical incident and how it is impacting on them. It can help the young person to express their thoughts, feelings and emotions in a safe environment with a caring adult. Learner s name Birth date Age Sex M F Group We are concerned about how things are going for you. Our talk today will help us to discuss what s going well and what s not going so well. If you want me to keep what we talk about just between us I will do that except for those things that I need to discuss with others in order to help you. For example, if you or someone else is at risk in any way, I cannot keep this confidential. My job is to help and I will need to do something about it. 1. Where were you when the event occurred? 2. What did you see or hear about what happened? 3. How are you feeling now? 4. How well do you know those who were hurt or killed? 5. Has anything like this happened to you or any of your family before 6. How will your life be different now? 7. How do you think this will affect your family in the days to come? 8. What bothers you the most about what happened? 9. Do you think anyone could have done something to prevent it? Who? 10. Thinking back on what happened not at all a little more than a little very much How angry do you feel about it? How sad do you feel about it? How guilty do you feel about it? How scared do you feel? What changes have there been in your life or routine because of what happened? 12. What do you usually do when you need help with a personal problem? 13. Which friends and who at home can you talk to about this? 14. What are you going to do when you leave the centre today? If you are uncertain, let s talk about what you could do. 24

25 R16: Checklist Young people at risk Handout for centres This checklist may be used by the guidance, counselling or psychological services practitioner or may be offered to centre staff who are concerned about a learner. It should be remembered that the checking of a number of items for any one person may point to other problems such as substance abuse or experience of abuse or neglect. Indication of a number of these factors in a person should always be followed up. Unexpected reduction in centre performance Talking about suicide Ideas and themes of depression, death and suicide in their work Making statements about hopelessness, helplessness or worthlessness Change in mood and marked emotionally instability Significant grief or stress Withdrawal from relationships Break up of an important relationship Discipline problems, being in trouble in the centre Withdrawal from extra-curricular activities Giving personal belongings away Loss of interest in things they used to care about Neglect of physical appearance Physical symptoms with emotional cause High risk behaviours Alcohol or drug abuse Bullying or victimization History of suicidal behaviour e.g. cutting, overdosing, risk-taking Family history of suicide/attempted suicide Excessive internet use 25

26 R17: Exploring suicide risk Guideline for centres The term 'risk assessment' is now used in quite a specific sense and such an assessment needs to be carried out by a trained professional. This note is intended to help those professionals (designated guidance, counselling and psychological service practitioners) most immediately available to the learner, to make a judgement as to whether a young person is at risk. Where there is a serious concern about a learner a referral should be made to the local Child and Adolescent Mental Health Service (CAMHS). Review available information: The centre should review any significant recent changes observed in the young people. The list of warning signs in R16 above could guide a review discussion with concerned staff. Have a sensitive but direct and open discussion with the learner. If a teenager has been reported to be talking about suicide, they should be asked openly, Are you thinking about killing yourself? This will offer the learner the opportunity to talk about their feelings and their thoughts. If they affirm that they have been thinking about it, then this should be explored by raising the following issues with the learner: Previous attempt: Has the learner attempted suicide before? You might ask, Have you ever tried to harm yourself before? If the answer to this is Yes, then the risk increases. Personal/family history: The level of risk increases with the number and seriousness of personal/family difficulties e.g. relationship breakdown, loss of friendship, problems with the law, parental separation, recent bereavement, serious illness etc. How have things being going for you recently; has anything significant happened in your life recently? Physical/emotional history: A young person who has experienced major personal difficulties, whether as a result of physical (recent hospitalisation, chronic illness) or significant emotional difficulties (depression, loneliness, guilt, anger etc.) is more at risk. How have things being going for you recently? Have you been ill? Has anything significant happened to you recently? Plan: Does the learner have a plan? How do you intend to do it? Does he/she have a particular day in mind? When are you thinking of doing it? Has he/she written suicide notes? The more concrete the plan the more serious the threat. Means: Does the young person have the means and a place to do it. Ask how do you intend to do it? Are the means available lethal? Have they access to a gun or pills? Where would you do it? Will the learner be in a place where they can be rescued? For example, do they intend to carry out the action when both parents are at work and their siblings are at school, at the centre or at work? The greater the number of Yes answers, the higher the risk and the greater the need for immediate onward referral of the learner. Parents should be informed at once and asked to bring the young person to their GP or, if outside surgery hours, to their local A&E for referral to an appropriate mental health service. (If a learner is under 18 years Staff members are obliged to inform the parents even without the young person's consent). The HSE Suicide Resource officer has information on the 2 day training in suicide intervention (ASIST programme). Don t be afraid to use the word suicide. Getting the word out in the open may help the learner feel that his/her cry for help has been heard. 26

27 R18: Frequently Asked Questions Guideline for coordinators/managers The following is a summary of questions that may be asked by Coordinator/Managers in the aftermath of a critical incident. Q. What do I do first on hearing news of the incident/death? A. If the source of the news is the affected family, express condolences and get as many facts as possible in a sensitive manner. If it is from another source, check for veracity; obtain the facts; the numbers injured etc. Ascertain who is to contact the next of kin. The Gardaí may have already undertaken this role. Q. Whom do I contact for help? A. If the centre is closed (weekends/days off) contact members of the centre s critical incident team to set up a meeting. Contact the relevant ETB or Board of Management personnel, and/or outside agencies e.g. Health Service Executive. If Junior Cert or Leaving Cert examinations are in progress, contact the State Examinations Commission (SEC) ( ) as soon as possible, in order to alert the Examination and Assessment Manager (EAM) for the centre. Q. What should I do first thing on the first morning back at the centre? A. Call a meeting of the critical incident team, if the centre has one. If not, call a meeting of ETB and BOM personnel along with the core staff team. Set up a critical incident team for the crisis duration. Q. What should be on the agenda for this meeting? A. 1. A statement of the facts as known 2. Delegation of responsibilities 3. Preparation of what to say to members of staff 4. Preparation of what to say to the centre s young people 5. Initial schedule for day. 6. Preparation of a letter to parents. 7. Discussion of support services/agencies whose support may be needed and who will contact them. 8. Preparation of a media statement if appropriate. Q. How do I handle all the phone calls? A. Staffing the telephone may be a stressful task. Assign one or two suitable people to take calls. Clear guidance should be given to those involved on what is appropriate to say. An agreed factual statement should be available to the telephone operators. It can also be read or faxed to the media. Q. How do I keep staff up to date? A. The staff room or the Coordinator/Manager s office is an important point of contact for staff. Informal briefings can take place during the breaks in addition to more formal meetings at the beginning and end of each day. Q. How do I dovetail the centre s part in the funeral/religious ceremonies with the wishes of the parents? A. The centre counsellor or local clergy/parish priest is the main link person here. Ensure that the parents wishes are respected and that participation of any learners or friends is agreed with them. Ensure that beliefs about death or particular customs about funerals of different religious groups are understood and respected. 27

28 Q. How do I handle staff members who want to opt out? A. All staff would be expected to attend meetings held to disseminate information. However, it should be made clear to staff at these meetings that opting out of support type work is acceptable. Be aware that some staff may be particularly vulnerable and watch out for them. Q. How do I handle the media? (See Section 8 Dealing with the media) A. Delegate one suitable person to deal with the media. Prepare a media statement. State that it is a difficult time for the centre community. Emphasis should be on what is being done to support staff and the learners. The Media Guidelines for the Portrayal of Suicide, suggest that the media can help prevent copy-cat suicides by 1) not mentioning specific details of the suicide e.g. location and method used, 2) not using colourful phrases to romanticise it and 3) not citing causes of suicide and thereby indirectly suggesting suicide as an option. The centre should adhere to these guidelines in any communication with the media. Allow limited and controlled access to the media by providing a press room. The Communications office of the State Examinations Commission (SEC) can help if the incident happens during exam time. Staff unions and management bodies may also have press officers who can advise. Q. What/when should I tell staff/the centre learners about the incident? A. Give the facts, as you know them. This is the best way to counter rumour and fantasy. It should be done as soon as possible to prevent staff and young people hearing from other, sometimes inappropriate, sources. Discuss the issue of posting photos and comments on Facebook or on other online social networks. Q. What if I feel upset myself and find it difficult to talk? A. It is very important to let young people know that it is natural and acceptable to be upset and to cry. It is better to share feelings with them than to hide them, so don t worry if you get upset. It may help to create a safe and open atmosphere for grief. You should also seek and accept support for yourself while dealing with this difficult event. Q. What if some young people do not appear to grieve? A. Young people do not need to be taught how to grieve. They will do it naturally and in healthy ways if we allow them and if we provide the safety, atmosphere, permission and example to do so. Don t assume that because overt signs are absent, the person is not grieving. Each individual has his/her own personal way of grieving. It is important that these different individual ways are respected and seen as normal. Q. How long does it take to come to terms with bereavement? A. There is no definite answer to this. Each individual progresses at his/her own pace and there are enormous variations. (See R9, R11, R12). Q. How soon should brothers and sisters or friends who are closely involved be encouraged to return to the centre? A. They should usually return fairly quickly. They need the support of their peer group and the routine of the centre will offer them a sense of normality. Their presence at the centre will offer others an opportunity to express their grief. The sooner they return the easier it is for them to reintegrate. This advice should, however, be tempered by any particularly unusual circumstances and decisions will ultimately be made by parents/guardians 28

29 Q. Where a lot of well-intentioned friends are calling to the house and perhaps staying out late at night, what should I advise a grieving family to do? A. Encourage them to set clear limits, when friends can call and when they should leave. Often the bereaved adults need to be reminded that setting clear limits is good. Friends may stay too long because they do not know when or how to leave the house. The centre can help by suggesting time limits to the friends. Q. What can I do about phone texting or internet chatting, especially if unreliable (or inappropriate) messages are being passed about? A. A critical incident highlights the need for a well-established internet and texting centre policy (AUP). Today s rapid technological communication crosses all boundaries and communities. All students/learners should be advised that they are being given reliable and up-to-date information by the centre. They should be encouraged to report any texts, s or internet information to a staff member that are at variance with known facts. 29

30 R19: Frequently Asked Questions Guideline for staff members The following is a summary of questions that may be asked by staff members in the aftermath of a critical incident. Q. I would like to opt out of support type work for personal reasons. Is this OK? A. Well-known staff members are the best people to support young people in the centre in times of distress. Young people need to be with people they know and trust. Accordingly, all staff members are encouraged to help young people at these times. However, nobody should be obliged to do this work and people should be able to opt out of if necessary. Reasons, such as recent personal bereavement, may make people more emotionally vulnerable than normal. However, staff who wish to opt out need to attend staff meetings where incident information is disseminated. Q. I have no qualifications to help out in this area. Shouldn t the job be left to the experts? A. You probably have more skills here than you realise. Your experience and competencies as a staff member and your skill in dealing with young people are invaluable. Most importantly, the learners here know you. Young people need a safe environment in which to come to terms with what has happened. This security is often enhanced by being able to discuss the events with a familiar adult face in the first instance. Q. What should I do in the centre to be helpful? A. You should acknowledge the situation and clarify the facts, as they are known. Honesty is essential. Encourage questions so that the learners have a clear understanding. You should try to establish normal routines as soon as possible but balance this with allowing the young people opportunities to discuss the incident and to express their thoughts and feelings. Encourage them to resume extra-curricular activities and help them to identify where they can go to for support. Encourage them to be supportive of one another. Q. What are the signs of grief that I may notice in learners? A. After bereavement young people may have a wide range of different reactions some may become quite and withdrawn, while others may be aggressive, irritable or angry. They may have mood swings or lack concentration. Try to handle all these normal reactions with patience, do not seem surprised by them and do not get impatient. If learners come from a background where there is family breakdown, serious illness, alcohol or drug related difficulties, then you need to take extra note of any behavioural changes. Q. What if I think that some young people are not grieving normally? A. There is no such thing as a correct way to grieve. Some people cry, some may laugh or become giddy, some show no reaction. The important thing is that all these different ways are natural and normal and you should try to help the young people understand this. Q. What skills do I have that are important? A. Listening skills are probably the most important. People who have experienced loss or trauma generally feel that talking helps them to cope with their feelings. When it is clear that a young person wants to talk, try to make the time. Be reassuring and patient while gently encouraging them to talk about the loss. Reassure the learner that you are there to help. 30

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